Impact of a supported housing prioritization system using vulnerability and high service utilization

For people experiencing chronic homelessness, supportive housing with intensive social, health, and behavioral health services reduces the likelihood of re-entering homelessness and the public costs of associated acute medical care, shelter use, and incarceration. Due to a limited supply of supportive housing, it must be allocated to those most in need. This paper examines findings from a unique, region-wide method for prioritizing individuals for supportive housing based on utilization of high-cost public services and vulnerability if left on the street. A sample of 196 individuals were prioritized for housing based on this method, while a comparison group of 102 were housed not using the method. Results showed that those housed under the prioritization method achieved greater reductions in utilization of high-cost public services, but were also less likely to have positive dispositions when exiting the housing programs, suggesting the need for a greater intensity of supports and/or multiple “doses” of supportive housing before stability can be expected. The method described in the paper can provide a starting point for developing regional, comprehensive systems of coordinated, prioritized entry into supportive housing, such as those now required by US Department of Housing and Urban Development.     

Sexual Self-Concept: Testing a Hypothetical Model for Men and Women

One theoretical concept receiving modest attention in contemporary sex research is the sexual self-concept (SSC). However, a lack of cohesion within this research has culminated in a collection of SSC models which overlap one another but which are not exactly the same. Therefore, a unified conceptual model of SSC needs to be established. In addition, little research has examined potential differences between genders in SSC, as most SSC research has focused on women. Using Buzwell and Rosenthal's 1996 Buzwell , S. , & Rosenthal , D. (1996). Constructing a sexual self: Adolescents’ sexual self-perceptions and sexual risk-taking. Journal of Research on Adolescence , 6, 489–513.[Web of Science ®] , [Google Scholar] sexual selves model as a theoretical basis, a six-factor higher-order latent SSC model was tested using confirmatory factor analysis. Lower-order factors for this model included multidimensional sexual self-esteem and sexual self-efficacy factors, as well as unidimensional arousal, anxiety, exploration, and commitment factors. A five-factor latent model (after removing the commitment and the resistance sexual self-efficacy factors) was the best-fitting model. This model was then tested for measurement and structural invariance between genders. Results indicated that while the measurement of SSC was similar between men and women, structural invariance did not hold, as men had a significantly higher latent SSC score compared to women. These findings have important implications for sexual self-concept research, as well as contributing to better understanding of human sexuality.     

Building an Integrated Research/Policy Planning Age-Friendly Agenda

This article describes an innovative model for integrating research into a policy and planning agenda aimed to help neighborhoods become more supportive of older adults. Philadelphia Corporation for Aging (PCA) established Age-Friendly Philadelphia (AFP) to catalyze efforts to improve the physical and social environments for seniors. The Research Program at PCA became an important part of this effort by providing multiple types of supports to PCA staff and other stakeholders. Most notably, the research program worked with planners to adopt the United States Environmental Protection Agency's Aging Initiative model for Philadelphia. That model focuses on (1) staying active, connected, and engaged; (2) development and housing; (3) transportation and mobility; and (4) staying healthy. Examples of practice efforts actualized using this research are also presented. By developing a new approach to the way research can support practice initiatives, AFP has been able to increase its effectiveness, and researchers have found better ways to work collaboratively with professionals in policy, planning, and practice. The PCA model should be considered as a framework for similar efforts aimed at creating age-friendly communities.     

The Relationship Between the Number of Types of Legal Gambling and the Rates of Gambling Behaviors and Problems Across U.S. States

In this article, we examine the relationship between the total number of types of gambling that are legal in a state and the gambling involvement of state residents. Of particular interest is whether more types of legal gambling are associated with higher rates of problem gambling. Telephone surveys of U.S. adults were conducted in 1999–2000 and 2011–2013. The same questions were used and the data sets were combined for most of the analyses. Gambling exposure was defined as the sum of the number of years that all types were legal. Results tabulated by state showed progressively higher rates of problem gambling, frequent gambling and any past year gambling as the number of legal types of gambling increased. Holding constant the number of legal types, problem gambling rates increased as exposure increased. States with longer exposure to legal lotteries or casinos tended to have higher rates of problem gambling. An analysis was also conducted in which the data sets from 1999 to 2000 and from 2011 to 2013 were compared. Among the states, there was a striking positive relationship between changes in the number of legal types of gambling between the two studies and changes in rates of frequent gambling between the two studies. For states that had fewer types of legal gambling in 2011 than in 1999, the rates of frequent gambling went down. For states that increased their types of legal gambling, rates of frequent gambling typically, but not always, went up. Possible explanations for these results were discussed.     

Exploring routine hospital antenatal care consultations — An ethnographic study

Background

Listening to women as part of their antenatal care has been recognized as valuable in understanding the woman’s needs. Conversations as part of routine antenatal interactions offer ideal opportunities for women to express themselves and for midwives to learn about the woman’s issues and concerns. The antenatal visit and the convention of antenatal consultations for midwives have not been well explored or defined and much of what takes place replicate medical consultative processes. As a consequence, there is little to assist midwives construct woman-centred care consultations for their routine antenatal care practice. This study showed how some practices were better in promoting the woman’s voice and woman-centred care in the hospital setting.

Therapists' Collusion with the Resistance of Rape Survivors

Based mostly upon a qualitative study of nine rape survivors, but also upon intensive review of the literature devoted to countertransference, vicarious traumatization, compassion fatigue, and burnout, this article examines collusive resistance, a process whereby therapists join clients to avoid confronting painful issues. It offers guidelines for the therapist to follow in the therapeutic dance to avert such collusion, and thereby to intervene more effectively especially with traumatized clients to facilitate their recovery actively, and, ultimately, to contribute to their true survivorship.     

Psychotherapeutic approaches to the cancer patient

Three basic therapeutic approaches applicable to the majority of cancer patients are outlined and illustrated with case vignettes. They are: (1) Initial catharsis and validation of feelings, (2) Restoring communication impaired by denial, and (3) Understanding the psychological meaning of the illness. Using this framework, the therapist's professional skills may be organized toward specific interventions, thereby stabilizing the associated ego functions against the regression often induced by the anxieties mobilized by working with seriously ill patients.     

Hedonism and the Family: Conflict in Values?*

In American society (and maybe all of the “Western world), there seems to be an increasing emphasis on instant gratification and avoidance of pain for its individual members. These two trends—one towards hedonism and the other involving the centrality of the rights of the individual—are closely connected. Both implicate basic values. Both have important effects upon the family. The purpose of this paper is to highlight issues related to these values, discuss their past and potentially future effects on the family, and reflect upon the role of the educator and helping professional in encouraging or discouraging certain biases among their students and clients and in the more general community.